Kansas Health Providers, Insurers Clash On Telemedicine

A committee of the Kansas Legislature examined complexities Friday of expanding the reach of telemedicine despite apprehension among insurance companies about reimbursement costs for care.

More than 30 states, including four that border Kansas, have sought to improve access to health care in rural areas by enacting laws requiring insurance plans to cover delivery of remote medical services provided via telecommunications systems.

During the 2017 legislative session, Kansas lawmakers considered two bills that would mandate companies offering coverage for telemedicine care to pay the same rate to providers as they would for in-person care. Companies not involved in telemedicine wouldn't be subject to the payment law. Neither bill made it out of the House, and the issue was kicked to an interim panel expected to make recommendations to the 2018 Legislature.

Eve-Lynn Nelson, director of the Center for Telemedicine and Telehealth at the University of Kansas Medical Center, told state legislators on a joint House and Senate health committee that specialists at the medical center witnessed the advantages for patients every day.

"We believe telehealth, when utilized wisely, can reduce provider practice costs, improve their productivity and facilitate triaging for special care," she said.

During the hearing, an official with Blue Cross and Blue Shield of Kansas City said imposition by the Legislature of a law requiring payment parity would force consumers to absorb rising payments to telemedicine providers in their insurance premiums.

"Telemedicine services are not equivalent to in-person services and, therefore, should not receive parity to in-person services in reimbursements," said Coni Fries, of BCBS-Kansas City. "Primary care physicians are paid at a higher rate because we expect them to manage our members' care throughout the year. On the contrary, telemedicine appointments might be one-time engagements."

During this year's legislative session, Blue Cross and Blue Shield of Kansas also opposed adoption of a state law on payment parity because of complications with pricing insurance policies.

Rachelle Colombo, who represents the Kansas Medical Society, said the Legislature should develop a new statutory framework around telemedicine that encourages usage while addressing standards of care and insurance coverage.

She said physicians and other clinicians providing telemedicine services to Kansans need to be licensed by the appropriate Kansas regulatory agency. Kansas law should require parity in insurance coverage and reimbursement for telemedicine services compared to in-person care, she said.

Credit: By Tim Carpenter timothy.carpenter@cjonline.com